Differential Diagnosis for Cough More Than 3 Weeks in a Toddler
Single Most Likely Diagnosis
- Viral upper respiratory infection (URTI): This is the most common cause of a prolonged cough in toddlers, as they are frequently exposed to various viruses that can cause URTIs, and their immune systems are still developing.
Other Likely Diagnoses
- Asthma: A common condition in children that can cause chronic cough, especially if triggered by viral infections or allergens.
- Allergic rhinitis: Allergies can lead to chronic cough due to postnasal drip.
- Reactive airway disease: Similar to asthma, this condition involves airway hyperresponsiveness and can cause cough.
- Pertussis (whooping cough): Although less common due to vaccination, it's still a possibility, especially if the child is not up to date on vaccinations or has been exposed to someone with pertussis.
Do Not Miss Diagnoses
- Pneumonia: Bacterial pneumonia can present with a prolonged cough and is a serious condition that requires prompt antibiotic treatment.
- Tuberculosis (TB): Although rare in many areas, TB is a critical diagnosis not to miss due to its serious consequences and the need for specific treatment.
- Foreign body aspiration: This is an emergency that can cause a sudden onset of cough and respiratory distress.
- Congenital heart disease: Certain heart defects can lead to chronic cough due to pulmonary congestion.
Rare Diagnoses
- Cystic fibrosis: A genetic disorder that leads to chronic respiratory infections and cough.
- Primary ciliary dyskinesia: A rare condition affecting the cilia in the respiratory tract, leading to chronic respiratory infections and cough.
- Immunodeficiency: Conditions that impair the immune system can lead to recurrent or chronic infections, including those causing cough.
- Gastroesophageal reflux disease (GERD): Can cause a chronic cough in toddlers due to acid reflux irritating the airways.